合并肝硬化食道胃底静脉曲张患者实施十二指肠镜下胆总管取石的护理探讨

Nursing Experience of Choledocholithotomy Under Duodenoscopy in Patients with Esophageal and Gastric Varices Complicated with Crrhosis

目的探究十二指肠镜下胆总管取石术治疗合并肝硬化食道胃底静脉曲张患者的护理方法与效果。方法纳入该院2013年1月—2017年12月收治的56例行十二指肠镜下胆总管取石术治疗的合并肝硬化食道胃底静脉曲张患者,并根据双盲法将其分为2组,对照组予以常规护理,观察组予以优质护理,并对两组患者的并发症、平均住院时间、生活质量评分以及护理满意度情况进行对比。结果对照组并发症发生率25.00%,高于观察组的0.00%(χ~2=8.000,P=0.005);观察组住院时间短于对照组(t=4.870,P=0.006);在生活质量评分方面,观察组患者躯体健康、疼痛、情绪、社会功能、心理健康、总体健康评分明显比对照组高(t=5.394 3、9.648 3、13.604 1、14.162 8、14.643 0、5.384 6,P=0.000);对照组患者满意度64.29%,观察组患者满意度92.86%,对照组患者护理满意度明显比观察组低(χ~2=6.787 9,P<0.05)。结论十二指肠镜下胆总管取石术治疗合并肝硬化食道胃底静脉曲张患者采用优质护理的临床效果显著,安全性较高,患者的护理满意度较高。

Objective To explore the nursing method and effect of choledocholithotomy under duodenoscopy for patients with esophageal and gastric varices complicated with cirrhosis.Methods From January2013to December2017,56patients with cirrhosis of the esophagus and gastric varices treated by choledocholithotomy under duodenoscopy were enrolled in this study.the patients were divided into two groups according to double-blind method.the control group was given routine care and the observation group was given high-quality care.the complications,average length of stay,quality of life score and nursing satisfaction of the two groups were compared.Results The incidence of complications in the control group was25.00%,higher than that of the observation group was0.00%(χ^2=8.000,P=0.005),and the time of hospitalization in the observation group was shorter than that of the control group(t=4.870,P=0.006).In terms of quality of life score,the scores of body health,pain,emotion,social function,mental health and general body health were significantly higher in the observation group than those in the control group(t=5.3943,9.6483,13.6041,14.1628,14.6430,5.3846,P=0.000),the satisfaction of the control group was64.29%,the satisfaction of the observation group was92.86%,and the nursing satisfaction of the control group was significantly lower than that in the observation group(χ^2=6.7879,P<0.05).Conclusion Choledocholithotomy under duodenoscopy in the treatment of esophageal and gastric varices complicated with liver cirrhosis has significant clinical effect,high safety and high satisfaction with nursing care.